Martin Browne (Tipperary, Sinn Fein)
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This engagement is with Dr. Orla Kelleher and Ms Joanna Curtis representing the Save Owenacurra Centre campaign.

Before we begin I wish to explain some limitations to parliamentary privilege and the practices of the House as regards references witnesses may make to other persons in their evidence. The evidence of witnesses physically present or who give evidence within the parliamentary precincts is protected by absolute privilege pursuant to both the Constitution and statute. Witnesses are reminded of the long-standing parliamentary practice to the effect that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory with regard to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with such a direction.

Before we hear from our witness, I propose that we publish her opening statement on the committee's website. Is that agreed? Agreed.

On behalf of the committee, I extend a warm welcome to Dr. Orla Kelleher and Ms Joanna Curtis. Dr. Kelleher has ten minutes to make her opening statement and there will then be questions and comments from members. Each member will have approximately ten minutes and members may speak more than once. I invite Dr. Kelleher to make her opening statement.

Dr. Orla Kelleher:

I am a niece of one of the residents of the Owenacurra Centre in Midleton and I am here today to advocate on my aunt's behalf. It is not easy for families like mine to share our story publicly. With Anna's permission, I will share her experience of living in the Owenacurra Centre and what the service means to her and to families such as ours. I will also highlight some problems with the closure and the steps we would like the Committee on Public Petitions to take.

My aunt, Anna, has lived at the Owenacurra Centre for over 25 years. Before moving to the centre, Anna was a patient at Our Lady's Hospital in Cork where she was in a closed ward for several years. My aunt has struggled with significant and enduring mental health problems since her twenties.

Owenacurra Centre was set up in 1988. It is a multipurpose service for people with severe and enduring mental health illness. It has a town centre location.

It is next to SuperValu and the Midleton market and within walking distance of lots of amenities. This has been key to rehabilitation, community integration and quality of life for many residents, including my aunt. It really is a life-saving and transformative service. Life has not been easy for Anna but being at the Owenacurra Centre has given her a chance to live the best life she can. When Anna first arrived at the centre, she found communication with people difficult, she was reluctant to leave the building and she could not go out for a short drive in my mother's car. However, over several years of rehabilitation and with the dedicated support of the Owenacurra staff, Anna gradually found her feet and flourished in Midleton. As a family, we are terrified that any move away from the centre, and Midleton, could result in a serious deterioration in her mental health and well-being.

The Owenacurra Centre is the only HSE long-stay adult mental health facility in east Cork and our only mental health respite facility. The centre has a capacity of 28 placements and can accommodate up to 20 residents in single rooms. In June 2021, the HSE announced its plans close the centre by 31 October 2021. At that stage, there were 19 residents. After a campaign mounted by Friends of Owenacurra, which is a coalition of residents, family members, local representatives and members of the community, the closure has been temporarily postponed. The reason for pushing out the closure date was that the HSE has not been able to find suitable placements for all the residents. Delaying the closure has been cold comfort to residents and family members. We have been informed that the centre is definitely closing but we have no idea when it will happen.

The closure process is ongoing and some residents have already moved. The number of residents has now been reduced to 11. To date, my family has had three family consultations to discuss Anna's future. These discussions have raised more questions than answers and have only increased our anxiety and worry about her future. For example, in September 2021, it was suggested that she would be moved out of the area to St. Stephen's Hospital in Glanmire, which is an institutional setting in the countryside, away from her friends and community in Midleton. This suggestion was very distressing for our family. Anna spent years in a closed ward and now, after the progress she has made at Owenacurra, she is facing the prospect of being sent back to an institutional setting. In December 2021, there was a conversation about another out-of-area placement in a house in Carrigaline. However, the building did not have planning permission and the proposal has been subject to a number of objections from local residents. Most recently, there was a vague suggestion that the HSE would look for a house in Midleton but no property has been identified.

The whole process has taken a severe toll on Anna and on our family. For Anna, the past 12 months have been extremely difficult. She has expressed her clear wish to remain in Midleton at the Owenacurra Centre, which is her home. She has had to endure terror and fear that she is going to be made homeless. She has had to watch her fellow residents, many of them friends, being sent off to different places around the county. She has had no news about how they are settling into their new accommodation and she is worried about them.

The stated reason for the closure is that the premises is not fit for purpose and no amount of refurbishment could bring it to an acceptable standard. The proposed closure was not signalled by recent Mental Health Commission reports, despite briefings from HSE management and communications to residents strongly suggesting that the commission's concerns contributed in significant part to the closure decision. The decision stemmed from an internal building report by the HSE's maintenance department. That report did not provide evidence of a new building survey that could support such a claim. Independent asbestos and fire safety reports, carried out in 2019 and 2021, respectively, set out the works that were required on the premises. Neither report supported the claim that the building was beyond repair or could not be brought up to an acceptable standard.

Despite repeated HSE briefings suggesting otherwise, no independent report has supported the HSE's position that the Owenacurra building is beyond repair. A member of the Oireachtas health committee who is a qualified architect with a specialist expertise in healthcare buildings visited Owenacurra, studied the building reports, concluded there was no reason the building could not be renovated and suggested this could potentially be done section by section, with the reduced number of residents remaining on site. After a thorough examination of the closure rationale, including a site visit to the Owenacurra Centre and St. Stephen's Hospital for comparison, the health committee wrote to Minister of State at the Department of Health, Deputy Butler, in April calling for a reversal of the closure as a matter of urgency and stating that the committee considered the evidence produced by the HSE justifying the decision to be "unconvincing". The committee repeated this opinion in a more detailed follow-up letter to the CEO of the HSE, Mr. Paul Reid, and the Minister of State in May and in a referral to the HSE board in recent weeks.

I will sum up what families of residents and the Save Owenacurra Centre campaign are seeking. It is important to emphasise that the campaign is not just about current residents, including my aunt. It is primarily about them but it is also about the many other people in east Cork with severe mental illness who require placements of varying duration to attain a decent quality of life. The campaign is not just about a few vocal families holding out against the HSE's planned closure; it is about a broader regional need into the future for a very vulnerable group of people. Families and others involved in the campaign want the Oireachtas health committee's detailed refutation of the closure to be upheld by the HSE. We want to see the building issues addressed in a manner that is not so disruptive that it leads to an almost total cessation of services over many years.

We are appealing to the HSE board to intervene and direct the executive to overturn the closure decision. The board was set up with the aim of building public trust and confidence in the HSE. The experience of families and many other supporters is that a vital service is being removed in a manner that just does not stand up to scrutiny. There appears to be no accountability for this. No amount of evidence of the distress of residents and family members or arguments from Oireachtas committees is making any difference to these proposals. It is extremely difficult to have trust in the HSE as a result of this attempted closure and how it has been handled. We ask the Committee on Public Petitions to write to the HSE board to reinforce the health committee's recommendation that the decision to close the Owenacurra Centre be reversed.

Martin Browne (Tipperary, Sinn Fein)
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I thank Dr. Kelleher. I have a number of questions for her, after which I will bring in other members. Going back to the start, when families were told the centre was closing, was there any consultation with any of them before that decision was made?

Dr. Orla Kelleher:

No, it was a real shock to us when we found out in June 2021 that it was closing. We did not know until then that it was a possibility.

Martin Browne (Tipperary, Sinn Fein)
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Were any concerns raised with families about the condition of the building? The report states that it was nearly falling down. Was any of that communicated to the families of residents?

Dr. Orla Kelleher:

Not that I am aware of.

Martin Browne (Tipperary, Sinn Fein)
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Has the Save Owenacurra Centre campaign been issued with any documents outlining the issues the HSE claims are the reasons for closing the centre and showing they are irreparable? In my constituency, we had more or less the same situation with St. Brigid's District Hospital in Carrick-on-Suir, with the same excuse given for closing it. However, the documentation we got does not stack up against what the HSE has been telling us is the reason for the closure. Have Dr. Kelleher and her colleagues received any of that type of documentation?

Dr. Orla Kelleher:

We have made various freedom of information requests to get access to information. We have had fire safety reports and asbestos reports setting out what work needs to be carried out, but they do not say the issues are beyond repair. There has not been any independent report, notwithstanding calls from family members and the Save Owenacurra Centre campaign for such a report. We have not had anything that stacks up, as in the situation in Tipperary to which the Chairman referred.

Martin Browne (Tipperary, Sinn Fein)
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Dr. Kelleher spoke in her opening statement about her aunt's situation.

Can you explain to the people who are watching the difference between an open ward and what your aunt had been in before and looks to be going back into now, and the effect that can have on someone like Anna?

Dr. Orla Kelleher:

Anna has lived for a long time, more than 25 years, in Midleton, at the Owenacurra Centre. Her progress at the start was slow. I remember when I was younger and we would visit Anna, she could not go for a short car journey because she would just not be able for it. Over the years in Midleton, with the dedicated support of the staff at Owenacurra Centre, who are absolutely phenomenal, Anna has gradually made progress. She goes out in the town every day, she is involved in the local craft group with really nice women, and she is totally integrated. She volunteers in the National Council for the Blind of Ireland, NCBI, charity shop. She goes to the leisure centre and goes swimming. She goes across the road to SuperValu. She is fully integrated. She goes across the road to the newsagents, Angela's, to get her cigarettes. She knows everybody around the town and it is such a joy to walk around town with her and to pop in for a coffee. Everybody knows her and she is so well-treated there whereas if she were to be somewhere else she would not have that community or those friends. The idea that someone could be in their 60s and be uprooted like that after 25 years of working really hard to get to that point is really heartbreaking for our family.

Pat Buckley (Cork East, Sinn Fein)
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I thank Dr. Kelleher for her bravery. It is not easy telling her own family's stories. At the outset, I am well aware of the Owenacurra Centre. It is in my own town. Listening to her last statement, there is a mixture of emotions between anger and sadness. She hit the nail on the head in that the HSE is going against its own policy and the Sláintecare policy of a community-led, fully supported, totally integrated centre. Dr. Kelleher explained it, from regression years ago to where her aunt is now. I have met her aunt and many of the people in town. This is personal. I do not wear the fact that the building is not fit-for-purpose because these issues were raised as far back as 2016. There is a number of reports there. I have said at meetings, even at the one in Sarsfield Court with the HSE, that people cannot be thrown out of their homes, especially when blaming the fact that the building is not fit-for-purpose. The HSE is the proprietor and is responsible for the upkeep of that building. It has failed and is putting the pressure on the residents of the Owenacurra Centre. I have heard of something similar happening in Tipperary and not too far away from Midleton, in the Castlemartyr health centre, the exact same excuse is given, that is, the building is not fit-for-purpose. It is on the main thoroughfare, the M25. It is in the village and yet the HSE wants to locate it six miles out the road where there is no access to it. Again, it is isolating and cramming people in.

The thing that bugs me is the fact that the campaign members have worked very hard on this. A long time ago we said we would not make it political. It is not about scoring points, but it is about supporting a system that works and has worked for years in Midleton. Dr. Kelleher is right. I have seen it and I know the residents who get the bus, who go to the supermarket and who go dancing. I will put it very bluntly here. I am not knocking the other locations the HSE is talking about but they are totally and utterly inappropriate for the residents of the Owenacurra Centre because they have been integrated into the town. It is all about location and access. To add to that, my fear and that of others is that the additional services at the Owenacurra Centre, not the premises, will be lost. There were 22 beds originally. Two of those beds are short-term respite, so that the individual and the family can get short-term respite. When the individual cmes in, they got a blood test, they are made comfortable, they have a shower and their feet are checked. If they need a chiropodist, one will be found. The dentist is across the road and the doctor, the hospital and the Garda barracks are nearby and the market is out the back. If that is not a model to be replicated and invested in, I cannot figure out the HSE.

We are 12 months down the road from the original closing date and the building is not fit-for-purpose or fit for the residents. If you go back to 2016, why has it been suitable for the last six years?

I want to thank the Joint Committee on Health because it has been supportive. This is one of my bugbears. We are supposed to be the legislators and the people who look after the citizens of this country. It will call it a recommendation or a conclusion but it is like the old story of the 40,000 troops marching. The mother says, "Look, 39,999 of them are out of step, but my Johnny is the only one who is walking right". This is the game I feel the HSE is playing. I want to put the health committee's letter on the record:

In light of the above we again recommend that you reverse the closure of the Owenacurra Centre and request that Cork/Kerry HSE pursue essential building works on the premises that have already been identified in independent reports. The reasons advanced by Cork/Kerry HSE for closing this highly valued service would, if applied elsewhere, lead to widespread closures of other mental health facilities, and are not credible grounds for such a drastic service decision in East Cork. The Owenacurra Centre has consistently received higher annual Mental Health Commission inspection compliance ratings than the two nearest continuing care facilities...

The two facilities are Glanmire and St. Catherine’s ward in Cork, so you are taking it from the boiling pot and putting in the fire. In addition, these are very isolated locations.

The letter continues, "The loss of the Owenacurra Centre, including its town centre location, would involve far-reaching adverse consequences for one of the most vulnerable groups of people attending the East Cork mental health services and would constitute a regression in their care and rehabilitation."

This is the recommendation from the committee to the HSE.

It is personal because mental health services are in my blood. Between 2000 and 2002, we had 69 suicides in east Cork. It is not a proud boast but it is a fact and I like dealing with facts. We have a very large cemetery in the town and it is called suicide row. We were labelled the suicide capital of the world in 2004. These are not boasting points. We are being told one of the finest working centres in east Cork that should be replicated as a pilot project is to close and the service is not needed. The excuse of the HSE is that the building is not fit-for-purpose.When these people are gone, nobody else is going to need the service and nobody else is going to get sick. That is totally unacceptable to me and I am bitter and angry that the witnesses, as family members, have to appear in front of any Oireachtas committee to fight their cause. It could be me, my parent or anybody's parent who could end up in this service.

This service is needed in Midleton. I spoke to a lady a number of weeks ago who called to that centre looking for help. She was woken by a garda on Sunday morning just after 7 a.m. She slept in her car. She was met by the staff, who are absolutely amazing, but they could not do anything because they were under the orders of the HSE. That lady told me that she put her own vomit into a bag and put it into the boot of the car. Obviously, she had nowhere to go to the toilet, so she put that bag into the boot of the car too. If that is the way we are treating the most vulnerable citizens in this country, the HSE is nothing short of an absolute disgrace. We are treating people as PPS numbers rather than treating the person.

I will finish on the next point because, Chair, I could be here until next Thursday.

HSE management has made many dismissive comments. We have tried to engage with them. I have received numerous replies to parliamentary questions on the matter. I have the official reports with me today. I have received 600 petitions asking for this service not to close. The most important thing here is not the actual building; it is the services provided, the service users and the residents who are using the services. Family members are visiting Leinster House today. I met them last week with the First Minister-designate, Michelle O'Neill. I will put it this way and will be polite about it. We were not refused entry to the Owenacurra Centre, but we were not facilitated by HSE management. Despite that, we went to the centre and we met with residents there. The people with me on the visit remarked how integrated the residents were. The HSE could take them out of the setting and send them to St. Stephen's Hospital in Sarsfield Court in Glanmire. It has been there since the 1950s. My own grandmother was incarcerated in there because she had TB, Lord have mercy on her. If that is how mental health services for elderly people are being progressed in this country, we should be absolutely and utterly ashamed. I will leave it at that.

Jerry Buttimer (Fine Gael)
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I welcome our witnesses from east Cork. Like Deputy Buckley, I wish to state that it is a pity that we are here today. I recognise that there is a balance to strike between the needs of the residents, who are citizens; the family members, who provided a powerful testimony today; and the report of the Mental Health Commission and the HSE. I was at the HSE briefing on the closure of Owenacurra a few weeks ago with Deputy Buckley. I have spoken to Deputies O'Connor, Stanton and Sherlock about the matter. I have to be honest. Like Deputy Buckley, my concern here is that we need to ensure, first of all, that the people who use the service in Owenacurra are housed, cared for and looked after in a building and a facility that is not just adequate, but meets their needs. That is my first point.

I might be speaking out of turn when I make my second point, because I was not at the meeting yesterday. I ask that following today's meeting we consider inviting representatives of the Mental Health Commission and the HSE to attend the committee. I accept the point that the proposed transfer of the service to different locations and the whole issue around the provision of the service has been very badly handled by HSE management. My only motivation is to ensure that a state-of-the-art residential unit is put in place for the residents. We must ensure that the continuum of care and service delivery is such that both family members and service users can be absolutely satisfied and quality of life is guaranteed for residents.

I would like to hear the views of Dr. Kelleher on the report of the Mental Health Commission and on the HSE estates management report, both of which have been presented to us. I thank the case manager for the excellent presentation that she gave today. The HSE estates management department is giving us a different view from what we have heard from the family members today. I ask for the views of Dr. Kelleher on the reports I mentioned previously. I thank the family members for being here today. I wish they did not have to attend the committee today to highlight the issue.

Dr. Orla Kelleher:

On the Senator's first question about the Mental Health Commission, we, as family representatives, along with our public representatives who have been involved in the campaign, have written to the Mental Health Commission asking that it consults the families on the closure of the centre and the process around it. However, the Mental Health Commission has stated that it is legally precluded from doing so, or from commenting on the closure. We are struggling with the fact that initially, the Mental Health Commissioner appeared on RTÉ Radio 1's "Drivetime" to discuss the issue. The position is that family members cannot be involved. As family members who are really struggling with the decision, we do not really know where to go. We would definitely like the Mental Health Commission to be involved.

The rationale for the closure has been based on a report published by the HSE estates management department. The report does not provide any evidence of a new building survey that supports the claim that the building is not fit for purpose. There are independent asbestos and fire safety reports that were published in 2019 and 2021. The reports set out the works that need to be done to bring Owenacurra up to standard. They do not state that the centre has to be closed down. The families-----

Jerry Buttimer (Fine Gael)
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Apologies, but I wish to ask a question. Deputy Buckley was with me on the day that we met HSE management in Ballincollig. I am not, for one second, intending to be confrontational here. I am actually trying to see how we can reach agreement on the issue. The HSE has stated in a report we have received that it is certain that there is no refurbishment that could deliver the quality of accommodation which the residents deserve, and in line with modern requirements and standards. As Dr. Kelleher mentioned in her presentation about her aunt, the HSE report states that it understands that moving to a new home will be difficult for each remaining resident, and regrets that it is not possible or safe to refurbish the existing building. The report goes on to state that the HSE is offering to provide a new type of ten-bed rehabilitative unit in Midleton. Like other members of the committee, I have to take what HSE management has said at face value. I appreciate that Dr. Kelleher might have a different view. On paper, it seems to me that there is a pretty clear choice. The new rehabilitative unit would be new, modern and fit for purpose. I ask Dr. Kelleher for her view on that.

Dr. Orla Kelleher:

My understanding is that there is no funding commitment, no planning permission and no building has been identified for the ten-bed unit that is being proposed. I am just speaking as a family member here. I am sure it would take a number of years before the new unit would be up and running. In the meantime, people like my aunt would be moved elsewhere. We are very concerned about the fact that one of the reasons being cited for the closure of the centre is that the rooms are too small. Yet, the alternative accommodation being offered to service users could potentially be on a ward. My aunt has her own room in Owenacurra. Some, but not all, of the rooms are small. There are only 11 residents in the centre at present. Deputy Hourigan, who has expertise in the area, has indicated that the building can be refurbished. She has even offered to provide expert guidance on that. She has suggested that the refurbishment could be done with some of the residents in situ. There are issues with asbestos, which is standard for a building of the centre's age. In Deputy Hourigan's opinion as an architect, those issues could be dealt with. Our concern is that there is no funding commitment for the alternative ten-bed unit in Midleton yet. It has been indicated that there is funding for a three- to four-bed unit, but we do not know any of the details. In the main, out-of-area placements have been offered to families. That is not what our family members want.

Jerry Buttimer (Fine Gael)
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I appreciate the effect the discommoding of family members would have and the disorientation involved in moving them away from familiar settings. I have one final question. My proposal still stands. This has been a very positive engagement. I thank the family members for being here.

The report we received at our most recent meeting with the HSE states that each resident is being assessed to ascertain what kind of placement would best meet his or her needs and that process is led by consultant psychiatrists. Where are we at with that in the case of residents of Owenacurra? Has that happened? What has been the level of engagement?

Dr. Orla Kelleher:

It is most appropriate for me to speak about the experience of my family. To date, we have had three consultations. There is nothing concrete being put on the table. It is very much maybe this-----

Jerry Buttimer (Fine Gael)
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My apologies for interrupting. When Dr. Kelleher states there has been no positive construction or points, what does she mean by that? What has she been told by the HSE? The committee is being given a different proposition, perhaps.

Dr. Orla Kelleher:

The mic might have picked that up wrong. We have not had a concrete proposal.

Jerry Buttimer (Fine Gael)
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Okay. Sorry.

Dr. Orla Kelleher:

In our first family consultation, my mum was informed that the HSE was suggesting that my aunt would be moving to an out-of-area service. That would be an institutional setting, so that-----

Jerry Buttimer (Fine Gael)
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Does an out-of-area service mean one completely out of Midleton?

Dr. Orla Kelleher:

She would be moved out of Midleton, to the countryside in Glanmire, where she would not be able to meet friends and family she has in Midleton.

Jerry Buttimer (Fine Gael)
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I thank Dr. Kelleher for her engagement. I am trying to broker a way here; she should not think I am trying to be confrontational.

Dr. Orla Kelleher:

There was a suggestion in respect of Carrigaline but that never materialised. There have been a lot of planning objections to that. The site there did not have planning permission and there were objections.

Jerry Buttimer (Fine Gael)
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Dr. Kelleher should take her time. I am trying to help her because I want to get a solution here. I thank her for what she is saying to us today because it helps us. We are getting a different side of the story and that is why this meeting is so important for those of us who are not in east Cork. I thank Dr. Kelleher for being here today. I hope she understands that we are trying to work together to ensure her aunt and other service users are looked after and treated properly.

Dr. Orla Kelleher:

My apologies for being a little bit emotional.

Martin Browne (Tipperary, Sinn Fein)
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No need to apologise.

Jerry Buttimer (Fine Gael)
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I thank Dr. Kelleher. It is important. It shows she cares. We care as well.

Dr. Orla Kelleher:

I thank the Senator. There was a suggestion for Carrigaline but it, too, is out of the area. My aunt does not have any connections to Carrigaline. We do not have family there. She would not have friends there or be integrated in the community. It would be very difficult for a person in her 60s to do that. Most recently, we heard that a three- or four-bedroom property in Midleton may be bought but there is no suggestion that she would be placed there. It has been very uncertain for our family.

Jerry Buttimer (Fine Gael)
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I thank Dr. Kelleher. I hope she did not think I was trying to be argumentative; I was not. I am trying to get information so that we can go back again to the HSE to have further engagement with it. That is why I am proposing that, arising from this meeting, if necessary we bring in the Mental Health Commission and the HSE to continue this discussion. This is a very important issue. I again thank the witnesses for being here. It is a matter on which the committee should have a private meeting before the recess.

Dr. Orla Kelleher:

I thank the Senator.

Martin Browne (Tipperary, Sinn Fein)
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For the information of Senator Buttimer, we planned to bring in the HSE. There is no problem with bringing in the Mental Health Commission or any other-----

Jerry Buttimer (Fine Gael)
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The Chairman will have my support if he does that before the summer recess or the week after we return. I will be happy to accommodate him in that regard.

Martin Browne (Tipperary, Sinn Fein)
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We will discuss that after this session and try to facilitate a meeting. I have no bother doing that but I cannot speak for all other members. We will see if we can get a meeting set up as soon as possible.

Emer Higgins (Dublin Mid West, Fine Gael)
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I support what the Chairman has said about bringing in the HSE, and also what Senator Buttimer said about bringing in the Mental Health Commission. That is a good suggestion.

My heart goes out to Dr. Kelleher. It is clear that she is passionate about this and loves her aunt dearly and wants her to be cared for. That is what we all want. We want her aunt and all the other residents to be delivered the service and care they deserve and to get it in a building that is fit for purpose. What the HSE is saying clearly to us is that the care is fit for purpose but, currently, the building is not. It is telling us that the service is badly needed but the building is the problem. I would like to ensure that all the residents get the care they need in a building that is fit for purpose and as accessible to family members as possible.

Is a day-care service being provided in the facility? Does Dr. Kelleher have any information in that regard?

I refer to the building works that the HSE is telling us cannot be done but in respect of which Dr. Kelleher has received guidance stating it is possible to do them. Has she received indications of costings of the work from the people to whom she has spoken who say it can be done?

Dr. Orla Kelleher:

I thank the Deputy. As regards day services, those ran pre-Covid. I think there are plans for them to be back up and running again in Midleton, but not at the Owenacurra Centre. That is my understanding but I am speaking as a family member rather than as someone who has clinical expertise on that. It is an important dimension to the service. What makes it so important to the east Cork area is the big impact it has on people's lives.

I do not have costings for the work. The families and those of us who have been campaigning to save the service have been seeking an independent report. We have written to the HSE asking it to allow us to commission an independent report but it has not responded positively to that. It stated that it is not possible to commission such a report. We do not have costings for the refurbishment of the Owenacurra Centre but that is something we would definitely like to see.

Emer Higgins (Dublin Mid West, Fine Gael)
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I thank Dr. Kelleher. That was very helpful. It will certainly be helpful to get the view of the HSE on costings and whether there is scope for an independent evaluation to be carried out. We may have a better sense of the issue once we hear from it on that particular issue. As Senator Buttimer stated, the Mental Health Commission will add value to this discussion. I thank the witnesses for coming before the committee. I am sure it was not easy.

Pat Buckley (Cork East, Sinn Fein)
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As I stated, in 2016 there were a few leaks in the building and cracks in the ceiling, and there was some plasterwork to be done. The estimated cost was €1,000 to do the cracks, €3,000 to repair the ceilings, €3,000 to fix the leaks and so on and €300 or so to put in a sink. Those are minuscule amounts of money. Those figures date from 2016, when the HSE had not spent money on the place. I have spoken to many people on this.

I agree with Senator Buttimer with regard to the HSE but I wish to touch on the issue of the Mental Health Commission. The spin from the HSE is that it is the commission's fault that the building is being closed. However, reports prepared by the commission each year from 2016 to 2020, inclusive, and three reports in 2021 outlined the structural deficiencies within the building or premises. The commission has been telling the HSE since 2016 that the building is not right and needs to be fixed. To draw a comparison, if you bring a car for its national car test, NCT, and it fails, you will get a snag list. When you fix those snags and bring it back to the NCT centre, the car will pass the test as it is roadworthy and fit for purpose. The HSE failed in that regard.

There are buildings similar to this one across the country. One could start naming all the towns in east Cork that have similar buildings. They were all built at around the same time, in the 1970s. If the commission were to inspect those buildings, it would say they are not fit for purpose. Are we facing a tsunami of closures of centres?

When this issue broke, a thing the members of the Owenacurra Centre said that resonates with me was not to move them, but to improve them. That is the most important point.

It was a simple request from the centre's residents and their families. Why would the Mental Health Commission not go into the centre? It is the organisation that calls out construction snags, in that it goes into a place, investigates and says what was wrong with it so that it can then be fixed and everything will work. The HSE claims that it is because of the Mental Health Commission's report that the HSE has to close the building.

Jerry Buttimer (Fine Gael)
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May I ask a question? Has HIQA been involved and made a report on Owenacurra?

Dr. Orla Kelleher:

My understanding is that this does not come within the remit of HIQA and that the Mental Health Commission is the appropriate body.

Pat Buckley (Cork East, Sinn Fein)
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That is where it breaks down. I am in favour of Senator Buttimer's suggestion. In our game, we listen to both sides of the story and somewhere in the middle is the truth. My bugbear is someone else being blamed for a body's failings over the years. My strong opinion is based on evidence that we have dating back to 2016, as well as the mix and match of reports. When we request fire safety reports, what we get compacted into a single document is something from 2016, the next page or two will relate to 2018 and then there will be half of a fire safety report from 2019. There is a great deal of misinformation and distortion, but the main issue is that we will lose all services for more than 94,000 people in east Cork, devastate the centre's residents and destroy their families. There is mention of three-bed units here and three-bed units there but, as Dr. Kelleher mentioned, there is nothing concrete. It is all just suggestion.

We have an ageing population, so I cannot understand why the HSE does not believe that we will not need these services in east Cork any more. You do not need to be a rocket scientist to know we will. There will be instances of people needing respite, be it short term or long term, but the HSE seems to be dismissing the need over a single point, namely, that the building is not fit for purpose. If it is not fit for purpose, then knock it and replace it with a state-of-the-art one, keep the 22 beds, keep all of its services, including the mental health day care and short-term respite, and improve it. When we lose those staff and services, they will be gone and we will be back here on some other committee - if we are lucky enough - being reactive instead of proactive and asking how we did not see it coming. It will be on our shoulders because we did not stand up for the people whom we are supposed to represent. Sometimes, we have to call people out and challenge them. If the centre is not fit for purpose, the HSE has a duty of care to the people in that area to replace it with something that does work and is fit for purpose and, instead of reducing services, to improve them and move forward.

I will leave it at that. I could get angry about this matter, and I am doing my best to hold my patience.

Martin Browne (Tipperary, Sinn Fein)
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Dr. Kelleher does not need to apologise to anyone here for getting upset. It is the system that should be apologising to her, her family and other families around the country. I apologise for not recognising Ms Curtis as being the person who brought this petition to us. The system is wrong. Dr. Kelleher is not wrong for worrying about her aunt, Anna, nor is any other family. It makes me angry as well because we have seen what is happening at St. Brigid's in Carrick-on-Suir, whose representatives we hope to speak to after the recess. There was no mention of St. Brigid's being unfit for purpose when we were told it was closing and staff were being moved due to Covid. It was not until the hospital was closed that problems with the building suddenly started appearing, something along the lines of what happened at Owenacurra.

As Deputy Buckley mentioned, there is talk of one of the possible solutions being a building from the 1950s. I was involved in building for 40 years and I assure the committee that, if there is asbestos in Owenacurra, then there is asbestos in the building that patients are possibly going to be placed in. I have no doubt about that whatsoever because that is what was being used at the time.

I agree with Senator Buttimer. We will invite the Mental Health Commission, or anyone else, to a meeting. HIQA was involved in St. Brigid's in the end. Despite requesting the engineer's report that says that the building is not fit for purpose, we did not get it or we failed to get adequate answers as to why Owenacurra, or anywhere else, was being closed down. In one of our meetings with the Minister of State with responsibility for mental health and older people, we were told that a further 350 beds were to be cut in the area's services. That will affect more small places like Owenacurra, St. Brigid's and so on. One of the solutions for St. Brigid's was to move them into private nursing homes, but that was no good to families. We have no public transport in south Tipperary, so a patient could be moved 25 miles away and family could not get there. I am sure that Dr. Kelleher's family visits daily. Families are visiting people in all of these hospitals daily. Suddenly, they are being told that their family members are being moved 25 or 30 miles away. That is not good enough.

I do not have further questions, but no member of the committee will disagree with me when I say that it is great to see how much Dr. Kelleher cares for her family member. She must not apologise to anyone for fighting to keep her aunt where she is happy and can be looked after. From listening to Deputy Buckley, Dr. Kelleher and Senator Buttimer, Owenacurra is a place that looks after family members, so they should not apologise to anyone for fighting to keep it open.

Dr. Orla Kelleher:

I thank the Chairman.

Martin Browne (Tipperary, Sinn Fein)
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Do Deputy Buckley and Senator Buttimer have further questions?

Jerry Buttimer (Fine Gael)
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No. I thank our guests for attending. The continuum of care and service is important. It is also important that there be engagement and that we ask the HSE to discuss the situation and explain it to us. I thank our guests.

Pat Buckley (Cork East, Sinn Fein)
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I thank our guests. I also thank the committee for listening and giving them a fair crack of the whip. Senator Buttimer was on the previous petitions committee with me. When we established this committee, it was known as "lastchance.com". The voices of the people we represent should be heard. If this is lastchance.com, our guests can see how strong the committee is. Listening to people as they air their opinions should not be taken for granted. This is a very strong committee. If we can move anything forward and improve matters, we will do so.

The staff of the Owenacurra centre and everyone associated with it are 110% committed to keeping it and its services open. All of the people in that building are friends. It will be a shame if its model is not replicated around the country. This might be personal to me, but I am here as a public representative and it is my job to represent people and give them their voice. It would be a shame if we did not build on this. "Do not move us, improve us." That is what should be done at this centre.

Martin Browne (Tipperary, Sinn Fein)
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Before we ask Dr. Kelleher to make a final comment, I thank Ms Curtis for bringing this petition to us.

Deputy Buckley referred to having petitions from 600 families. It is easy to get caught up in numbers and pins stuck in boards and maps, but behind every number and every pin is a family member like Dr. Kelleher's aunt. The top level of the HSE needs to start recognising that and that this is not just about moving people around.

I thank our guests for attending. Does Dr. Kelleher have further comments to make?

Dr. Orla Kelleher:

I thank the committee for its invitation and its support.

I reiterate our call that, if in a position to do so, the committee write to the board of the HSE to ask it to support our call and the call of the Joint Committee on Health to reverse the decision to close the Owenacurra centre.

Martin Browne (Tipperary, Sinn Fein)
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The recommendation we had was to invite the HSE to come before us. However as Senator Buttimer said we also asked the commission to come before us and anybody else in order to try to get answers on such issues as the Owenacurra Centre. I thank the witness.